Andrea Lee Linna and
Michael Podberesky and associate Amanda Ray co-authored a July article published by
Compliance Today magazine on the likely increase in telehealth fraud enforcement by the
Office of Inspector General and the Department of Justice.
The article examined recent DOJ enforcement actions regarding two
high-value telehealth fraud schemes, as well as OIG and Medicare Payment
Advisory Commission pronouncements on telehealth oversight and
The authors noted that some industry stakeholders have questioned whether
the actions targeted by the OIG and DOJ constitute telehealth fraud, and
the OIG has not clarified whether there is a distinction between telefraud
and noncompliance with Medicare telemedicine requirements. Ultimately,
however, judges and juries will determine whether telehealth billing errors
resulted from confusion and good-faith efforts or reckless indifference,
deliberate ignorance or willful misconduct.
The article concluded with a list of telehealth compliance best practices
that providers should consider adopting to decrease the risk of facing OIG
or DOJ scrutiny of telehealth claims.